Supported Living LD
All about supported living
It is true to say that many individuals, including those with the most complex needs, have been successfully supported in their own homes, using detailed 'person centred planning'.
Supported living has opened up access to a much wider range of housing options for people with a learning disability, including 'general needs' social housing and even home-ownership.
Although it is too early to make an overall judgement about the relative cost of supported living there is evidence that this is not unmanageable; for some individuals the cost of their housing and support arrangements has actually been lower than the residential care they were previously using.
The separation of housing and support featured in supported living makes additional sources of funding available. This both eases the pressures on purchasers' budgets and ensures that most individuals with learning difficulties will have a higher disposable income than would be the case in residential care.
The development of supported living
Reflecting an increasing frustration with the inherent limitations of residential care, the last five years have seen increasing interest within the UK in the idea of 'supported living'; enabling people with learning difficulties to live in their own homes, providing flexible, individualised support to people wherever that might be.
Following a Harkness Fellowship visit to the US by Peter Kinsella, the National Development Team established a programme to promote the idea of supported living, providing for the first time a much more coherent framework for developing these ideas.
Kinsella set out five basic principles for supported living services. These included:
- separating out housing and support
Instead of having to take on packages of residential care, more flexible combinations of housing and support can be developed.
- focusing on one person at a time
By moving away from the model of the group home, and using detailed 'personal futures' planning to provide services that are genuinely individualise.
- zero rejection
Nobody should be seen as 'too disabled' to live in their own home.
- providing people with much more control over their homes and their lives
People's homes are centred on their own concerns, not those of the organisations providing services.
- a focus on relationships
People's links (their family, their friends, their community) are the starting point in designing services, not an afterthought. Through the use of 'support tenants' (who share the home with the disabled person and can provide or seek assistance as necessary) and circles of support, people's relationships are kept right at the forefront.
The significance of separating out housing and support
Although all the principles are crucial in defining the character of supported living, the idea of separating out housing and support plays a central role.
The separation of housing and support is a key factor. This has a number of significant repercussions, including:
- promoting security of tenure
- increasing individuals' incomes
- opening up different sources of funding
The flexibility of supported living has enabled commissioners to open up a much wider range of options than the traditional specialist housing providers, including:
- the private rented sector
- 'general needs' social housing
- home-ownership options (including access to the Housing Corporation's shared ownership programme)
Supported living does not involve some simple blueprint for new services. Rather, it requires the application of a radically different way of thinking about housing and support. This complexity has inevitably led to some confusion both amongst critics and supporters of the idea. For example, supported living has erroneously and variously been described as:
- only about people with learning difficulties living on their own
- completely informal
('We don't have any procedures here')
- relying entirely on 'commitment' without the need for skilled or experienced personal assistance
Because supported living is seen as 'progressive' some organisations have been keen to use the term for services that do not meet the criteria outlined earlier.
At the same time there has been some active opposition to the development of supported living, including for example:
- a housing department refusing to pay housing benefit to people with high support needs on the grounds they 'ought' to be in residential care.
- a social services department that announced that people whose financial concerns were being managed by the Court of Protection would not be able to hold a tenancy.
These arguments are often based on entirely inappropriate 'blanket' assumptions about the capacity of people with learning difficulties. Implicitly, they represent an attempt to limit the rights of one group of people to live in their own home.
However, far from offering substantial protection, the Registered Residential Home model of care can undermine the security of individuals.
People who live in registered settings often:
- have less security of tenure
- are isolated (living in 'enclosed worlds')
- are financially poor
- have standards imposed on them that are inappropriate in people's own homes
Equally it should not be implied that supported living should be unregulated, or that people in supported living situations would not be abused. Indeed many involved in setting up supported living arrangements had established a range of structural mechanisms for ensuring that people have some protection.
- 'voluntary' registration and contract compliance to higher (and more appropriate) standards than required through registration
- ensuring people are not isolated or under the control of one organisation
- the checks and balances inherent in having a separate landlord and support provider
- greater security of tenure
- more control for the person with learning difficulties
In particular, the separation between housing and support makes it possible to change one without having to change the other - a key and fundamental position of good practice for Commissioners of Supported Living services. This in turn could make it much easier for Tenants to:
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- change services that are not working as they should or
- to simply give Tenants the option of choice in determining for themselves how and who will support their housing or care services in future without necessarily having to change both.